Tuesday, April 10, 2012

The Titanic and The Health Divide

While tragic events can bring the issue of inequality to the
headlines every once in a while, it’s more often a problem that lives under the
radar of most people. Yet, as the
gaps between rich and poor continue to grow wider and wider and health care
coverage remains an important issue, there’s no better time to take a deeper
look at the important links that exist between race, class and health.

That health can be impacted by factors like race and class
isn’t breaking news. Health disparities have likely been around since the dawn
of civilization, and one of the starkest and most well known examples of health
disparities is now a hundred years old: The sinking of the Titanic. On that fateful night in April, 1912, over
1500 souls perished. But the
tragedy wasn’t felt equally across all groups on the ship. A close look at the passenger list,
revealed that third class passengers died at a significantly greater rate than
those of the second and first class passengers who paid the more expensive
fares.

Such disparities continue to track race and class today when
you look at a number of important health outcomes. African-Americans die from heart disease and stroke at a
greater rate than any other group.
They’re also more likely to have hypertension, and along with American
Indians, share the highest rates of diabetes.

For cancer, the picture is much the same. African Americans
experience cancer rates that are more than twice as high as American Indians,
about 50 percent higher than Hispanics and Asian/Pacific Islanders, and 10
percent higher than whites. Racial and ethnic differences in cancer mortality
are even more pronounced, with African Americans again having the highest
rates.

Looking outside of race, factors like income and education
level--so called socioeconomic factors--also have a large influence on health: so much so that many in the health field
call poverty itself a carcinogen. Rates
of heart disease, stroke, and diabetes are also higher in those with lower
income and less education.

Why do these disparities exist? The simple answer is that there are a lot of different
reasons. Unequal access to quality
health care and screening services is one very important one. But there are other important issues
around education, language, and living/work environments—to name just
three. Tied together with such things,
race and income are also often linked to important health risk factors like
smoking, being less active and being overweight.

Clearly, the issue of health disparities is very complex and won’t be solved
overnight. But, the situation is far from hopeless. Awareness of the issue is on the rise, and state and local
communities are starting to take concrete steps to fix the problem—whether its
offering universal health insurance or helping bring better food choices to
poor neighborhoods.

It’ll be a mix of such small and large steps that eventually
help fill the health divide in the United States.